[Drug therapy of detrusor dysfunction]

Abstract

In a urodynamic study, the effect of carbachol, distigmine and prostaglandin-F2 alpha on neuropathic detrusor areflexia and on the non-contracting detrusor as well as the effect of scopolamine, emepronium bromide and flavoxate on the idiopathic unstable bladder and neuropathic detrusor hyperreflexia were examined. Carbachol and distigmine do not have any effect on detrusor contractility but reduce the bladder capacity by decreasing the detrusor compliance. The instillation therapy by prostaglandin-F2 alpha provokes detrusor contractions in some cases of non-contracting detrusor. Emepronium bromide and flavoxate therapy of the idiopathic unstable bladder and neuropathic detrusor hyperreflexia showed improvement of the subjective symptoms, but not of the urodynamic findings. The oral therapy of scopolamine has no effect on overactive detrusor function. Treatment of the idiopathic unstable bladder by prolonged detrusor distension with the aid of peridural anaesthesia showed satisfactory results in more than 50%.